caa a22 4500 388034343 CHVBK 20180307125000.0 cr unu---uuuuu 161130e199808 xx s 000 0 eng 10.1086/647877 doi S0195941700088469 pii (NATIONALLICENCE)cambridge-10.1086/647877 Is Streptococcus pneumoniae a Nosocomially Acquired Pathogen? [Elektronische Daten] Streptococcus pneumoniae is most prominently a major cause of community-acquired infections of the respiratory tract, central nervous system, and bloodstream, but there is an increasing interest in its role in the epidemiology of hospital-acquired infections. Penicillin-resistant pneumococcal strains appeared 3 decades ago and now are present worldwide, often displaying multiple resistance due to antibiotic selective pressure. Horizontal spread can cause either sporadic cases or hospital outbreaks, primarily in younger children and elderly patients. Pneumococcal transmission from one patient to another can be documented by polymerase chain reaction or pulsed-field gel electrophoresis typing. Nosocomial acquisition of infection, along with pediatric age, previous hospitalization, and previous β-lactam therapy, are the main risk factors significantly associated with penicillin-resistant pneumococcal infections. Nosocomial acquisition also is associated with higher mortality from pneumo-coccal disease. The importance of penicillin resistance as a risk factor significantly associated with higher mortality from pneumococcal infection is found in some studies, but not in others. Mortality from pneumococcal pneumonia is approximately the same for human immunodeficiency virus (HIV)-infected patients without acquired immunodeficiency syndrome (AIDS) as for HIV-negative subjects, but it is significantly higher in AIDS patients. Penicillin-resistant strains are involved in the vast majority of hospital outbreaks, whether presenting as clinically manifest infection or a simple colonization. Pneumococcal vaccination is recommended universally in order to lower the incidence of invasive infection, although a number of problems can limit its effectiveness. Copyright © The Society for Healthcare Epidemiology of America 1998 Paradisi Franco Infectious Disease Unit, University of Florence School of Medicine, Florence, Italy Corti Giampaolo Infectious Disease Unit, University of Florence School of Medicine, Florence, Italy Infection Control & Hospital Epidemiology Cambridge University Press 19/8(1998-08), 578-580 0899-823X 19:8<578 1998 19 ICE https://doi.org/10.1086/647877 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1086/647877 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Paradisi Franco Infectious Disease Unit, University of Florence School of Medicine, Florence, Italy NATIONALLICENCE 700 1- Corti Giampaolo Infectious Disease Unit, University of Florence School of Medicine, Florence, Italy NATIONALLICENCE 773 0- Infection Control & Hospital Epidemiology Cambridge University Press 19/8(1998-08), 578-580 0899-823X 19:8<578 1998 19 ICE CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-cambridge